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HTHGS: Sex & Back Pain  

Ask Alex,
Last year my husband ruptured a disk in his back. He has recovered somewhat and is now listed with a permanent disability.  His disability is small and he can do most things but with pain.  Our sex life is actually pretty good.

But I have a few questions.
1.  My husband has never been very open about sex and when I try to bring it up or ask questions on what he likes or would like, I always get "I don't know".  How do I get him to open up about it?
2. With his back being bad he has a really hard time being on top, what types of positions can we do?  He is not hung like a horse (to put it bluntly) and we are both out of shape. I am getting a little bored being on top.
3. I have a hard time climaxing during intercourse without direct clitoral stimulation. What can I do to help get this stimulation or help with getting to climax?
I also wanted to say keep up the GREAT job. This site has been a lot of help and I look forward to getting the newsletters.

Dear Jo, 
My first suggestion for the two of you is to get into shape. Simply put, sex requires physical energy.  Furthermore, strong back and stomach muscles strengthen ones bodies natural ability to heal/maintain herniated discs.  In your husband’s situation it is especially important.  This is not to say that getting in shape cause the two of you to automatically have great sex, but it can’t hurt.  Second, good communication skills are key.  Start by talking to each other about what works well. Specifically each of you should answer the following three questions.  A) The best sex that we ever had was when . . . B) I was most turned on by you when . . .  C) I like it when you . . . . . D) The one thing that I have never done, but would like to try is . . . .  Then, in bed, get creative.  Good sex does not require a healthy back. A good sex life requires a little bit of creativity to find ways to seduce your partner both with the idea that the physical stimulation that they are about to receive is the best ever and that they are emotionally wanted and visually sexy.  For example, oral sex, depending upon the type of herniation can be given while laying down, sitting down, sideways, upside down, or any which way. 

In regards to what positions are best for intercourse, it all depends a lot upon what type of back injury your husband has.  Some people with back injuries can’t lay down and others can’t sit.  Thus for some the best position is to be on top, on bottom or even on the side.  The particulars depends upon your partners condition, which you did not specify. 

Thus, I highly recommend ordering the book and/or the video called “Sex and Back Pain” by Lauren Herbert. Lauren Herbert’s book goes into great detail discussing which positions are best suited for each particular type of back problem. 

The best part of the book / video, besides the graphic information, is the presentation style.  Watching or reading a “how to” video/book is a great tool for facilitating conversations.  Talking about the book / video ideas is a great way to create enough distance from such a loaded topic so that it becomes safe to say what your likes and dislikes are without directly referencing your partner.  Furthermore, it may give the two of you some ideas of what will likely work.   

Lastly in terms of needing direct stimulation for your orgasm, I suggest that you tell him this and give him several ideas as to how you would like to be touched. In addition, you could incorporate masturbation into your sexual play with your partner. This way you will not only be able to pleasure yourself exactly the way you like it, but you will also be teaching your partner about how you like to be touched, and best yet he can join you in your masturbation and cause you to feel even more sensations that what you could do for yourself alone!  

The book is distributed by
The Saunders Group.
H. Duane Saunders, MS, PT
4250 Norex Drive
Chaska, MN 55318-3047

(this book is given out free to patients at The Mass General Hospital and the hospital at the University of Pennsylvania. I imagine that you can find it at most of the other major hospitals in the US for free too).

  In addition, Lauren Herbert produced a video called “Sex and Back Pain”
To order this video, write to
Impacc USA
One Washington Street
Greenville, ME 04441

This tip was originally written by Alex Robboy, LSW



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The Founder: "Alex" Caroline Robboy, LCSW, QSW, CAS

Ms. Robboy is the Founder and Chief Executive Officer of The Center for Growth Inc and How To Have Good Sex Inc.  Alex practices marriage and family therapy and sex therapy, and also conducts periodic seminars about human sexuality throughout the northeastern United States.

Ms. Robboy graduated from the University of Pennsylvania where she earned a Masters degree in Social Work, a Certificate of Advanced Studies in Human Sexuality Education and a Post-Masters Certificate in Marriage Counseling & Sex Therapy. Through the American Board of Sexology, she is a board certified sexologist and through the American Association of Sex Educators Counselors and Therapists a certified sex therapist.  Additionally, she is a licensed clinical social worker and a member of the American Board of Marriage and Family Therapy.


  Our Philosophy sex is like dancing, it changes every time. It depends on culture, atmosphere and mood. Sometimes it is done alone, with a partner or in a group. It can be fast and hard or slow and soft. Sex is a combination of non-verbal negotiation and verbal cues: a scream, a twitch of the toes, or a flush of the face. There is no one 'right' way to move, only what feels good to all those involved. 
     The purpose of this site is to share information. Thus, if you have any ideas, thoughts or information that you believe others might benefit from, please e-mail your tip to and I  will be sure to include it on either our weekly newsletter or here on the actual website. 

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